This has been called the most significant contract since 2004, and with good reason. There have been a number of huge announcements, with several new pots of funding, and more details to be announced imminently.
The main headlines include:
- Billions to be invested in practice funding through five-year GP contract.
- Guaranteed increase in global sum this year. This year, £109m will be invested into the ‘core practice contract’. It’s not clear how much will go direct into the global sum, but it is an increase. In following years, the amount put into the core practice contract will increase significantly. This year’s comparatively low increase reflects the money put into the state indemnity scheme.
- NHS to fund all staff indemnity on top of global sum increase. There had been hints that the global sum would be decreased to fund the indemnity scheme. But, under the scheme, the NHS will cover indemnity costs for all GPs and practice staff. This will be on top of the global sum increases every year for the next five years.
- Practices given £2 per patient to join networks under new DES. The new DES is ‘voluntary’, but NHS England and the BMA expect 100% take up. To qualify for the funding from July 2019, practices will simply need to join networks and appoint a clinical lead. Following that, they will have to work towards seven ‘service specifications’ based on the aims of the NHS long-term plan.
- NHS England to fund 22,000 practice staff to support GPs. Under the new contract, networks will receive 70% of the funding to employ a pharmacist, a paramedic, a physio, a physician associate and 100% of the funding for a social prescriber.
- GPs should be ‘better off’ under new contract, according to medical accountants. However, reassurance is needed that the new primary care networks – which practices will be mandated to join – will have a good legal structure and will not incur any hidden tax bills.
- QOF will be reformed to remove ‘unnecessary indicators’ under new GP contract. The framework is to be reformed, to bring in ‘clinically-proven improvements’ for the management of prevalent conditions such as diabetes and blood pressure control and improvements to the management of heart failure, asthma, COPD, and mental health.
- GPs on more than £150k a year of NHS funding to be named. Under a new ‘transparency drive’, a new mechanism will be introduced to identify and name GPs on more than £150k per year from NHS sources from 2020. This will apply to all managers too.
- GPs will not have to pay for rising employer pension contributions. The agreement states: ’General practice will not have to bear any additional costs’ of the increase in employer contributions’. It’s not clear how NHS England intends to ensure this.
- In order to avoid the problems of pensions taxation, all parties are exploring the potential for GPs to choose to halve the rate at which their pension builds up, and in return pay half rate contributions.
- NHS 111 direct booking into practice appointments at a rate of one appointment per 3,000 patients available per day.
- Increased digital access for patients, meaning practices will be able to make 25% of appointments bookable online.
- £20m annual funding for practices to deal with subject access requests following the removal of the ability to cover costs under GDPR legislation. Practices will also have access to a data protection officer through their CCG to provide support on GDPR issues. This will form part of the global sum.
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